Gilula's lines

Anatomical lines used in wrist radiography

Gilula's lines

Diagram showing Gilula's lines on a wrist X-ray.

Gilula's lines are three smooth curves that are used in the evaluation of wrist radiographs, particularly in the assessment of the carpal bones. These lines help in identifying carpal alignment and detecting any disruptions that may indicate fractures or dislocations.

Anatomy of the wrist

The wrist is composed of eight carpal bones arranged in two rows. The proximal row includes the scaphoid, lunate, triquetrum, and pisiform bones. The distal row consists of the trapezium, trapezoid, capitate, and hamate bones. These bones articulate with each other and with the distal ends of the radius and ulna to form the wrist joint.

Description of Gilula's lines

Gilula's lines are used to assess the alignment of the carpal bones on a posteroanterior (PA) view of the wrist. The lines are described as follows:

First Gilula's line

The first line is drawn along the proximal articular surfaces of the scaphoid, lunate, and triquetrum. This line should be smooth and continuous without any steps or breaks.

Second Gilula's line

The second line follows the distal articular surfaces of the scaphoid, lunate, and triquetrum. Like the first line, it should also be smooth and continuous.

Third Gilula's line

The third line is drawn along the proximal articular surfaces of the capitate and hamate. This line should also be smooth and without any interruptions.

Clinical significance

Disruption of Gilula's lines can indicate a carpal instability or fracture. For example, a break in the continuity of the first or second line may suggest a scaphoid fracture or a lunate dislocation. Accurate interpretation of these lines is crucial for diagnosing wrist injuries and planning appropriate treatment.

Related pages

• Carpal bone
• Wrist joint
• Scaphoid fracture
• Lunate dislocation